Parents

Preparing Your Child for Anesthesia

Providing Support

If your child needs to have an operation, you probably have plenty of questions, many of them about anesthesia. You may wonder if your child will feel pain during the operation, be aware of what's going on, wake up in the middle of the surgery and be scared, or not feel well afterward.

The concept of your child being unconscious or losing sensation in the body can be unnerving, especially when you're entrusting his or her health and well-being to someone else. But anesthesia today is very safe. Unlike anesthesia of the past, when doctors often used nothing more than ether and a stethoscope, modern anesthesia in hospitals and surgery centers is administered by highly trained professionals who use a wide range of safe medications and monitoring equipment.

Whether your child is scheduled for a minor outpatient procedure or major surgery that requires recovery time in the hospital, it's important for you to be prepared to support your child. The more educated, calm, and reassuring you are about the surgery and the anesthesia, the easier the experience is likely to be for both you and your child.

What Kids May Fear

Kids' age and developmental level play a large role in what they find scary about receiving anesthesia. Some kids, especially younger ones, may fear being separated from their parents. So they may feel more secure being with mom or dad in a preoperative holding room or induction room until falling asleep.

Older kids, however, may have much more complex fears: exposure of body parts during surgery, cutting and scarring of the body, waking up during surgery, loss of control, pain after surgery, and even death.

One common concern among kids, young and old, is whether they'll receive a needle and, if so, if it will hurt. A kind of local anesthetic cream can be rubbed on the skin to remove the pain of needle pricks when starting an intravenous (IV) line. This usually works well to soothe fears of getting a "shot."

And, depending on the type of surgery and anesthesia being used, in many cases kids can drink medication to help them relax and feel sleepy before going into the operating room. Also, children often are given an inhaled anesthetic so they can breathe themselves to sleep in the operating room before an IV is placed.

Talking to Your Child About Anesthesia

It may help your child handle the stress and uncertainly of the procedure or surgery if you have a conversation ahead of time about what to expect. Here are a few talking points to consider:

Let your child know where you'll be during the whole experience. Reassure your child that you'll be in the waiting room nearby during the surgery and in the recovery room when he or she wakes up after the surgery. You may also be able to sit with your child until he or she falls asleep before the surgery. Discuss this with your anesthesiologist.

And explain that (in many outpatient procedures), your child can come home soon after the surgery is done. In cases that require hospitalization, most hospitals avoid separation anxiety by permitting at least one parent to stay with the child day and night.

Give your child age-appropriate and developmental stage-appropriate information. For a younger child, for example, less information may be better than more. That doesn't mean lying — it just means giving the most appropriate information for your child's age and developmental stage. Giving young kids very detailed explanations might make the experience more frightening or worrisome. Of course, every child is different, so have a discussion based on your child's needs.

Consider saying something like, "A special doctor will give you a little medicine to make you sleep very deeply so that you won't feel anything during the operation." Or you may just want to explain that all he or she has to do is breathe (if your child is getting general anesthesia or will be sedated using a mask). In many cases, the IV and breathing tubes are placed after kids are asleep, so they will have no knowledge or awareness that some other potentially frightening things are even happening.

But preteens and teens, especially, may need to be reassured that they will not wake up during the procedure but that they will wake up afterward.

Avoid frightening language. For example, don't say, "You'll be given gas" or "You'll be put to sleep." A child may confuse "gas" with the fuel that can poison or kill, and confuse "put to sleep" with what happened to an ailing family pet. Also avoid saying, "You'll be taking a nap" — young kids may think all future naps mean surgery. Likewise, you should never tell children that they'll be stuck with a needle if they misbehave or don't cooperate.

Answer questions honestly. If you don't know the answer to a question, reassure your child that you will ask the doctor.

Explain that the anesthesia will prevent your child from feeling any pain during the procedure.

Explain that there may be some pain and discomfort after the surgery, but that the doctor can give medicine to help. It's important for kids to understand that they don't have to try to be brave or "put on a happy face" after surgery. Explain that it's OK to let the doctor know about any pain or discomfort so that your child can get help right away.

Explain that it's normal to feel a little weird after surgery. Although every person has a different experience, a child who was sedated or had general anesthesia may feel groggy, confused, chilly, nauseated, scared, alarmed, or even sad when the medications wear off. That's all perfectly normal. You may want to tell your child, "You might wake up feeling a little funny, but that's OK. I will be there with you."

Make sure whatever you tell your child is in line with what the doctor has told you. Don't pass on any misinformation — it may scare your child if something happens that's different from what you've explained.

Let your child know that it's normal to not remember anything about the surgery. That's one important aspect of general anesthesia.

Encourage your child to read about the present safety of anesthesia. Then share the information with the family — reading and sharing information is an excellent coping mechanism.

Staying Calm

As you discuss the hospital and surgery, remember to use nonverbal cues to communicate assurance: your tone of voice, facial expressions, gestures, and body language convey powerful messages. If you appear fearful, your child is likely to feel scared or confused regardless of the words you use to explain things. That's why it's important to try not to cry or become emotional in front of your child before or after the procedure. If you need to vent your emotions, try to take a few minutes to step out of the room where your child can't see or hear you.

If you're a calm, supportive, and soothing presence for your child before and after surgery, the whole experience will probably be easier and far less stressful for you both.